Integrated care systems

A whole-system approach to health and social care

Throughout the COVID-19 pandemic, key workers across health, social care, the voluntary sector and local communities have shown their incredible ability to tackle a crisis. This took a monumental effort from frontline staff and there were many examples of smarter working and closer collaboration across health and care systems – examples further proving the value that can be derived from integrated care systems.

Now, the Government’s health and social care White Paper, Integration and innovation: working together to improve health and social care for all, has outlined ambitions to build on the NHS Long Term Plan by embedding the depth of collaboration and innovation seen through the pandemic. The aim is to shape a system that’s better able to serve patients, staff and populations in a fast-changing world.

As well as addressing the specific focus areas of the White Paper – such as developing place-based partnerships and increasing collaboration across acute providers – we see three foundational principles all system stakeholders should adopt to capture the ingenuity seen during the pandemic and build a positive human future for patients, staff and populations:

  • Focus on purpose first. Looking beyond statutory and governance requirements to set out how change will advance the goal of improving outcomes for local populations and patients.
  • Create an empowered culture. Empowering teams to shape new ways of working that go far beyond following the national guidance.
  • Embrace agility. Supporting the speed and flexibility of the new ways of working experienced during the pandemic.

While structural and legislative reform across the NHS will be challenging, we believe these changes present extraordinary opportunities. Read on to explore how health and care leaders can build a system that’s more collaborative, innovative and responsive, and that harnesses the best of modern technology.

Governance, people and leadership

Strong governance provides the structures and processes that will facilitate the transition to more integrated care, ensuring operational control and accountability across the organisations within the system. But good governance alone won’t enable greater integration and new models of service delivery. Visionary leadership that focuses on purpose, people and innovation will be key to ensuring reform delivers real transformation in health and care systems. Both governance and leadership of integrated care systems should focus on empowering stakeholders by devolving and distributing power, and creating a culture that embraces innovative and agile ways of working.

Designing for the whole system

Integrated care systems are an opportunity to improve our health, wellbeing and quality of life with more preventative, holistic and people-centred services. But achieving this relies on the right system design. As organisations integrate their delivery models and coordinate enablers such as finance, data and digital across the system, they’ll need to balance clear and ambitious long-term goals with an achievable, iterative approach. While successful models will look different across the country, pursuing an inclusive design process that builds energy and commitment from partners will be key. This means being clear on the guiding purpose, assessing existing levels of maturity and designing new structures that can better involve and support local partners and programmes.

New models for collaboration

Greater integration and collaboration across all areas of health and social care was critical to the success of pandemic responses. Supporting further collaboration that allows systems to design and deliver services that are truly tailored to population needs is a fundamental driver of the new whitepaper. Place-based partnerships and provider collaboration models are complementary approaches with critical roles in new system designs. Both will require diverse stakeholder groups to work together effectively, with a collective vision, leadership, structures and delivery processes. These deeper models of integration will be essential to maximising the integration opportunities and avoiding the frustrations experienced with sustainability and transformation plans (STPs).

Harnessing innovative technology together

During the pandemic, the adoption of digital technology and the integration of richer data moved at an unprecedented pace, with clear benefits for patients and staff. This will continue to be fundamental to enabling healthcare organisations to work together. Whether it’s setting up the digital infrastructure that allows for the safe and effortless sharing of patient data, defining system-level strategic priorities and developing operational models, or empowering staff and clinicians with the tools and information to make decisions, innovative technology and robust data pools will improve patient care and staff experiences.

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